Nicholson Joanne, Heyman Miriam, English Kelly, Biebel Kathleen
The Heller School for Social Policy and Management, Institute for Behavioral Health, Brandeis University, Waltham, MA, United States.
The Heller School for Social Policy and Management, Lurie Institute for Disability Policy, Brandeis University, Waltham, MA, United States.
Front Psychiatry. 2022 Apr 7;13:801065. doi: 10.3389/fpsyt.2022.801065. eCollection 2022.
Despite the importance of family and parent-focused practice, there has been a dearth of research on interventions for parents with mental illness. This paper describes the process and outcome of adapting an evidence-based intervention, Let's Talk about Children (LTC), in the context of adult mental health services in Massachusetts, United States.
Specific objectives included: (1) to specify the core components, functions, and principles of LTC essential to adapting the intervention (i.e., program theory), (2) to consider contextual factors related to the new setting; (3) to pre-test the adapted materials with diverse practitioners; and (4) to compile the program model and materials (i.e., the practice profile) for use by adult mental health service providers in Massachusetts. The Adaptation Team included individuals with expertise in psychiatric rehabilitation and clinical care, policymaking, program development and research, and parents. Activities occurred between 2015-2019 and included: (1) consulting with experts to specify the core elements and theory behind the selected intervention (i.e., with the LTC purveyor and international experts); (2) consulting with key stakeholders for input regarding the Massachusetts target population and context to inform adaptations (i.e., individual and group key informant interview sessions); (3) pretesting the initial adapted materials (i.e., training and coaching sessions with adult mental health practitioners); and (4) using feedback to refine and compile the final intervention manual (i.e., the ParentingWell Practice Profile). Participants reflected diverse, oftentimes multiple roles and perspectives, including those of parents with mental illness, adult children, and family members.
ParentingWell is practitioner- and setting-agnostic, addresses parenting across the lifespan, fits into the routine workflow, and builds on practitioners' existing skills. Eight themes emerged, which were translated into four core elements (engage, explore, plan, access and advocate) consistent with Self-Determination Theory and four underlying principles (trauma-informed, strengths-based, family-focused, culturally sensitive) in keeping with the LTC model. The ParentingWell Practice Profile operationalizes each core element and addresses the underlying principles.
ParentingWell makes talking about parenting and family experiences a routine part of the therapeutic conversation with adults with mental illness. Future research will test the adaptation, implementation, and impact of ParentingWell.
尽管以家庭和父母为中心的实践很重要，但针对患有精神疾病的父母的干预措施的研究却很匮乏。本文描述了在美国马萨诸塞州的成人心理健康服务背景下，对循证干预措施“聊聊孩子”（LTC）进行调整的过程和结果。
具体目标包括：（1）明确调整该干预措施（即项目理论）所需的LTC的核心组成部分、功能和原则；（2）考虑与新环境相关的背景因素；（3）与不同的从业者对调整后的材料进行预测试；（4）编制项目模型和材料（即实践概况），供马萨诸塞州的成人心理健康服务提供者使用。调整团队包括在精神康复和临床护理、政策制定、项目开发与研究方面具有专业知识的人员以及父母。活动于2015年至2019年期间开展，包括：（1）与专家协商，明确所选干预措施背后的核心要素和理论（即与LTC供应商和国际专家协商）；（2）与关键利益相关者协商，获取有关马萨诸塞州目标人群和背景的信息，以为调整提供参考（即个人和小组关键信息访谈）；（3）对初步调整后的材料进行预测试（即与成人心理健康从业者进行培训和辅导）；（4）利用反馈意见完善并编制最终的干预手册（即“育儿有方实践概况”）。参与者反映了多样的、通常是多重的角色和观点，包括患有精神疾病的父母、成年子女和家庭成员的角色和观点。
“育儿有方”与从业者和环境无关，涵盖了整个生命周期的育儿问题，适合日常工作流程，并建立在从业者现有技能的基础上。出现了八个主题，这些主题被转化为与自我决定理论一致的四个核心要素（参与、探索、计划、获取和倡导）以及与LTC模型一致的四个基本原则（创伤知情、基于优势、以家庭为中心、文化敏感）。“育儿有方实践概况”对每个核心要素进行了操作化，并阐述了基本原则。
“育儿有方”使谈论育儿和家庭经历成为与患有精神疾病的成年人进行治疗性对话的常规部分。未来的研究将测试“育儿有方”的调整、实施和影响。
